“You can’t close hospitals and let people die to prove a point.” So spoke the conservative Republican mayor of Belhaven, North Carolina, Adam O’Neal, this morning at a press conference at the state Legislative Building in Raleigh.

O’Neal’s appearance (and his linking of hands with Rev. William Barber of the North Carolina NAACP) was the highlight of a powerful event at which advocates called on Gov. McCrory and legislative leaders to reverse course and admit that their ideologically-driven decision to refuse to expand the state’s Medicaid program under the terms of the Affordable Care Act is threatening the physical health of hundreds of thousands of North Carolinians and the financial health of dozens of hospitals — especially ones located in poorer, rural communities like Mayor O’Neal’s.

O’Neal’s speech was an especially moving and courageous act by a man who claimed to disagree with Rev. Barber on most issues and who obviously placed any political ambitions he might harbor at risk by so publicly breaking with the leaders of his own party. But it was also obviously heartfelt and genuine — a fact that made it all the more powerful.

O’Neal’s action today was also clearly motivated by facts “on the ground” in his own community. As has been reported here previously[3], the rural hospital in Belhaven, Vidant Pungo Hospital, has been on life support in recent months due to the state’s failure to expand Medicaid.

According to O’Neal it is simply wrong to, in effect, force the rural citizens of communities like his Beaufort County to become “soldiers” in an ideological battle.

Let’s hope O’Neal’s message resonates with Gov. McCrory, Speaker Tillis and Senate Pro Tem Berger and that, at a minimum, it signifies the emergence of a widening crack in the opposition of North Carolina conservatives to Medicaid expansion (as has occurred in so many other states).